Depression, the secret we share | Andrew Solomon | TEDxMet


Translator: Shlomo Adam
Reviewer: Reiko Bovee “I felt a funeral in my brain, and mourners to and fro kept treading, treading till I felt that sense was breaking through. And when they all were seated, a service, like a drum, kept beating, beating, till I felt my mind was going numb. And then I heard them lift a box and creak across my soul with those same boots of lead again, then space began to toll, as if the heavens were a bell and being were an ear, and I, and silence, some strange race wrecked, solitary, here. Just then, a plank in reason broke, and I fell down and down and hit a world at every plunge, and finished knowing then.” We know depression through metaphors. Emily Dickinson was able
to convey it in language, Goya in an image. Half the purpose of art is to describe such iconic states. As for me, I had
always thought myself tough, one of the people who could survive if I’d been sent to a concentration camp. In 1991, I had a series of losses. My mother died, a relationship I’d been in ended, I moved back to the United States from some years abroad, and I got through all
of those experiences intact. But in 1994, three years later, I found myself losing interest
in almost everything. I didn’t want to do any of the things I had previously wanted to do, and I didn’t know why. The opposite of depression is not happiness, but vitality, and it was vitality that seemed to seep away
from me in that moment. Everything there was to do seemed like too much work. I would come home and I would see the red light
flashing on my answering machine, and instead of being thrilled
to hear from my friends, I would think, “What a lot of people that is,
to have to call back.” Or I would decide I should have lunch, and then I would think, but
I’d have to get the food out and put it on a plate and cut it up and chew it and swallow it, and it felt to me like
the Stations of the Cross. And one of the things that often gets lost in discussions of depression is that you know it’s ridiculous. You know it’s ridiculous while
you’re experiencing it. You know that most people manage to listen to their messages and eat lunch and organize themselves to take a shower and go out the front door and that it’s not a big deal, and yet you are nonetheless in its grip and you are unable
to figure out any way around it. And so I began to feel myself doing less and thinking less and feeling less. It was a kind of nullity. And then the anxiety set in. If you told me that I’d have to be depressed for the next month, I would say, “As long I know it’ll be
over in November, I can do it.” But if you said to me, “You have to have acute anxiety
for the next month,” I would rather slit my wrist
than go through it. It was the feeling all the time like that feeling you have
if you’re walking and you slip or trip and the ground is rushing up at you, but instead of lasting half a
second, the way that does, it lasted for six months. It’s a sensation
of being afraid all the time but not even knowing
what it is that you’re afraid of. And it was at that point
that I began to think that it was just too painful to be alive, and that the only reason
not to kill oneself was so as not to hurt other people. And finally one day, I woke up and I thought perhaps I’d had a stroke, because I lay in bed completely frozen, looking at the telephone, thinking, “Something is wrong
and I should call for help,” and I couldn’t reach out my arm and pick up the phone and dial. And finally, after four full hours
of my lying and staring at it, the phone rang, and somehow I managed to pick it up, and it was my father, and I said, “I’m in serious trouble. We need to do something.” The next day I started
with the medications and the therapy. And I also started reckoning with this terrible question: If I’m not the tough person who could have made it
through a concentration camp, then who am I? And if I have to take medication, is that medication making me
more fully myself, or is it making me someone else? And how do I feel about it if it’s making me someone else? I had two advantages
as I went in to the fight. The first is that I knew that,
objectively speaking, I had a nice life, and that if I could only get well, there was something at the other end that was worth living for. And the other was that I had
access to good treatment. But I nonetheless emerged and relapsed, and emerged and relapsed, and emerged and relapsed, and finally understood I would have to be on medication and in therapy forever. And I thought, “But is it
a chemical problem or a psychological problem? And does it need a chemical cure
or a philosophical cure?” And I couldn’t figure out which it was. And then I understood that actually, we aren’t advanced enough in either area for it to explain things fully. The chemical cure
and the psychological cure both have a role to play, and I also figured out that
depression was something that was braided so deep into us that there was no separating it from our character and personality. I want to say that the treatments we have for depression are appalling. They’re not very effective. They’re extremely costly. They come with innumerable side effects. They’re a disaster. But I am so grateful that I live now and not 50 years ago, when there would have been almost nothing to be done. I hope that 50 years hence, people will hear about my treatments and be appalled that anyone endured such primitive science. Depression is the flaw in love. If you were married
to someone and thought, “Well, if my wife dies,
I’ll find another one,” it wouldn’t be love as we know it. There’s no such thing as love without the anticipation of loss, and that specter of despair can be the engine of intimacy. There are three things people
tend to confuse: depression, grief and sadness. Grief is explicitly reactive. If you have a loss and you feel
incredibly unhappy, and then, six months later, you are still deeply sad, but
you’re functioning a little better, it’s probably grief, and it will probably
ultimately resolve itself in some measure. If you experience a catastrophic loss, and you feel terrible, and six months later
you can barely function at all, then it’s probably a depression
that was triggered by the catastrophic circumstances. The trajectory tells us a great deal. People think of depression
as being just sadness. It’s much, much too much sadness, much too much grief at far too slight a cause. As I set out to understand depression, and to interview people
who had experienced it, I found that there were people who seemed on the surface to have what sounded like relatively mild depression who were nonetheless
utterly disabled by it. And there were other people
who had what sounded as they described it like terribly severe depression who nonetheless
had good lives in the interstices between their depressive episodes. And I set out to find out what it is that causes some people to be more resilient than other people. What are the mechanisms that allow people to survive? And I went out and I interviewed
person after person who was suffering with depression. One of the first people I interviewed described depression as a slower way of being dead, and that was a good thing
for me to hear early on because it reminded me that that slow way of being dead can lead to actual deadness, that this is a serious business. It’s the leading disability worldwide, and people die of it every day. One of the people I talked to when I was trying to understand this was a beloved friend who I had known for many years, and who had had a psychotic episode in her freshman year of college, and then plummeted
into a horrific depression. She had bipolar illness, or manic depression, as it was then known. And then she did very well for many years on lithium, and then eventually, she was taken off her lithium to see how she would do without it, and she had another psychosis, and then plunged into the worst depression that I had ever seen in which she sat in
her parents’ apartment, more or less catatonic,
essentially without moving, day after day after day. And when I interviewed her about
that experience some years later — she’s a poet and psychotherapist
named Maggie Robbins –” when I interviewed her, she said, “I was singing ‘Where Have
All The Flowers Gone’ over and over to occupy my mind. I was singing to blot out the
things my mind was saying, which were,
‘You are nothing. You are nobody. You don’t even deserve to live.’ And that was when
I really started thinking about killing myself.” You don’t think in depression that you’ve put on a gray veil and are seeing the world through the haze of a bad mood. You think that the veil
has been taken away, the veil of happiness, and that now you’re seeing truly. It’s easier to help
schizophrenics who perceive that there’s something
foreign inside of them that needs to be exorcised, but it’s difficult with depressives, because we believe
we are seeing the truth. But the truth lies. I became obsessed with that sentence: “But the truth lies.” And I discovered, as I talked
to depressive people, that they have many
delusional perceptions. People will say, “No one loves me.” And you say, “I love you, your wife loves you,
your mother loves you.” You can answer that one pretty readily, at least for most people. But people who are
depressed will also say, “No matter what we do, we’re all just going to die in the end.” Or they’ll say, “There can be
no true communion between two human beings. Each of us is trapped in his own body.” To which you have to say, “That’s true, but I think we should focus right now on what to have for breakfast.” (Laughter) A lot of the time, what they are expressing
is not illness, but insight, and one comes to think
what’s really extraordinary is that most of us know about
those existential questions and they don’t distract us very much. There was a study I particularly liked in which a group of depressed and a group of non-depressed people were asked to play
a video game for an hour, and at the end of the hour, they were asked how many little monsters they thought they had killed. The depressive group was usually accurate to within about 10 percent, and the non-depressed people guessed between 15 and 20 times as many little monsters,
(Laughter) as they had actually killed. A lot of people said, when I chose
to write about my depression, that it must be very difficult to be out of that closet,
to have people know. They said, “Do people
talk to you differently?” And I said, “Yes, people
talk to me differently. They talk to me differently insofar as they start telling me
about their experience, or their sister’s experience, or their friend’s experience. Things are different because now I know that depression is the family secret that everyone has. I went a few years ago to a conference, and on Friday of the three-day conference, one of the participants
took me aside, and she said, “I suffer from depression and I’m a little embarrassed about it, but I’ve been taking this medication, and I just wanted
to ask you what you think?” And so I did my best to give
her such advice as I could. And then she said, “You know, my husband would never understand this. He’s really the kind of guy to whom
this wouldn’t make any sense, so I just, you know,
it’s just between us.” And I said, “Yes, that’s fine.” On Sunday of the same conference, her husband took me aside,
(laughter) and he said, “My wife wouldn’t think that I was really much
of a guy if she knew this, but I’ve been dealing with this depression and I’m taking some medication, and I wondered what you think?” They were hiding the same medication
in two different places in the same bedroom.
(laughter) And I said that I thought communication within the marriage might be triggering
some of their problems. (Laughter) But I was also struck by the burdensome nature of such mutual secrecy. Depression is so exhausting. It takes up so much
of your time and energy, and silence about it, it really does make the depression worse. And then I began thinking
about all the ways people make themselves better. I’d started off as a medical conservative. I thought there were a few
kinds of therapy that worked, it was clear what they were — there was medication, there were certain psychotherapies, there was possibly
electroconvulsive treatment, and that everything else was nonsense. But then I discovered something. If you have brain cancer, and you say that standing on your head for 20 minutes every morning
makes you feel better, it may make you feel better, but you still have brain cancer, and you’ll still probably die from it. But if you say that you have depression, and standing on your head
for 20 minutes every day makes you feel better, then it’s worked, because depression is
an illness of how you feel, and if you feel better, then you are effectively
not depressed anymore. So I became much more tolerant of the vast world
of alternative treatments. And I get letters,
I get hundreds of letters from people writing to tell me
about what’s worked for them. Someone was asking me backstage today about meditation. My favorite of the letters that I got was the one that came from a woman who wrote and said that
she had tried therapy, she had tried medication,
she had tried pretty much everything, and she had found a solution
and hoped I would tell the world, and that was making
little things from yarn. (Laughter) She sent me some of them.
(Laughter) And I’m not wearing them right now.
(Laughter) I suggested to her that she
also should look up obsessive compulsive disorder in the DSM.
(Laughter) And yet, when I went to look
at alternative treatments, I also gained perspective
on other treatments. I went through
a tribal exorcism in Senegal that involved a great deal of ram’s blood and that I’m not going
to detail right now, but a few years afterwards I was in Rwanda working on a different project, and I happened to describe
my experience to someone, and he said, “Well, you know, that’s West Africa,
and we’re in East Africa, and our rituals are
in some ways very different, but we do have some rituals
that have something in common with what you’re describing.” And I said, “Oh.”
And he said, “Yes,” he said, “but we’ve had a lot of trouble with
Western mental health workers, especially the ones who came
right after the genocide.” And I said, “What kind
of trouble did you have?” And he said, “Well, they would do this bizarre thing. They didn’t take people
out in the sunshine where you begin to feel better. They didn’t include drumming or music
to get people’s blood going. They didn’t involve the whole community. They didn’t externalize the depression as an invasive spirit. Instead what they did was they took people one at a time into dingy little rooms and had them talk for an hour about bad things
that had happened to them.” (Laughter) (Applause) He said, “We had to ask them
to leave the country.” (Laughter) Now at the other end
of alternative treatments, let me tell you about Frank Russakoff. Frank Russakoff had the worst depression perhaps that I’ve ever seen in a man. He was constantly depressed. He was, when I met him,
at a point at which every month he would have
electroshock treatment. Then he would feel sort of
disoriented for a week. Then he would feel okay for a week. Then he would have a week
of going downhill. And then he would have another
electroshock treatment. And he said to me when I met him, “It’s unbearable to go through
my weeks this way. I can’t go on this way, and I’ve figured out how
I’m going to end it if I don’t get better. But,” he said to me,
“I heard about a protocol at Mass General for a procedure called a cingulotomy, which is a brain surgery, and I think I’m going to give that a try.” And I remember being amazed at that point to think that someone who clearly had so many bad experiences with so many different treatments still had buried in him
somewhere enough optimism to reach out for one more. And he had the cingulotomy, and it was incredibly successful. He’s now a friend of mine. He has a lovely wife
and two beautiful children. He wrote me a letter
the Christmas after the surgery, and he said, “My father sent me two presents this year, First, a motorized CD rack
from The Sharper Image that I didn’t really need, but I knew he was giving it
to me to celebrate the fact that I’m living on my own and have a job I seem to love. And the other present was a photo of my grandmother, who committed suicide. As I unwrapped it, I began to cry, and my mother came over and said, ‘Are you crying because of the
relatives you never knew?’ And I said, ‘She had
the same disease I have.’ I’m crying now as I write to you. It’s not that I’m so sad,
but I get overwhelmed, I think, because
I could have killed myself, but my parents kept me going, and so did the doctors, and I had the surgery. I’m alive and grateful. We live in the right time, even if it doesn’t always feel like it.” I was struck by the fact that depression is broadly perceived to be a modern, Western, middle-class thing, and I went to look at how it operated in a variety of other contexts, and one of the things
I was most interested in was depression among the indigent. And so I went out to try to look at what was being done for
poor people with depression. And what I discovered is that poor people are mostly not being treated
for depression. Depression is the result
of a genetic vulnerability, which is presumably evenly
distributed in the population, and triggering circumstances, which are likely to be more severe for people who are impoverished. And yet it turns out that if you have a really lovely life but
feel miserable all the time, you think, “Why do I feel like this? I must have depression.” And you set out to find treatment for it. But if you have a perfectly awful life, and you feel miserable all the time, the way you feel
is commensurate with your life, and it doesn’t occur to you to think, “Maybe this is treatable.” And so we have an epidemic in this country of depression among impoverished people that’s not being picked up
and that’s not being treated and that’s not being addressed, and it’s a tragedy of a grand order. And so I found an academic who was doing a research project in slums outside of D.C., where she picked up women who had
come in for other health problems and diagnosed them with depression, and then provided six months
of the experimental protocol. One of them, Lolly, came in, and this is what she said
the day she came in. She said, and she was a woman, by the way, who had seven children. She said, “I used to have a job but
I had to give it up because I couldn’t go out of the house. I have nothing to say to my children. In the morning, I can’t wait
for them to leave, and then I climb in bed and
pull the covers over my head, and three o’clock when they come home, it just comes so fast.” She said, “I’ve been taking
a lot of Tylenol, anything I can take
so that I can sleep more. My husband has been telling me
I’m stupid, I’m ugly. I wish I could stop the pain.” Well, she was brought into
this experimental protocol, and when I interviewed her
six months later, she had taken a job working in childcare for the U.S. Navy, she had left
the abusive husband, and she said to me, “My kids are so much happier now.” She said, “There’s one room
in my new place for the boys and one room for the girls, but at night, they’re just
all up on my bed, and we’re doing homework
all together and everything. One of them wants to be a preacher, one of them wants to be a firefighter, and one of the girls says
she’s going to be a lawyer. They don’t cry like they used to, and they don’t fight like they did. That’s all I need now is my kids. Things keep on changing, the way I dress, the way I feel,
the way I act. I can go outside not being afraid anymore, and I don’t think those bad feelings
are coming back, and if it weren’t
for Dr. Miranda and that, I would still be at home with
the covers pulled over my head, if I were still alive at all. I asked the Lord to send me an angel, and he heard my prayers.” I was really moved by these experiences, and I decided that I wanted
to write about them not only in a book I was working on, but also in an article, and so I got a commission from
The New York Times Magazine to write about depression
among the indigent. And I turned in my story, and my editor called me and said, “We really can’t publish this.” And I said, “Why not?” And she said, “It just is too far-fetched. These people who are sort of at
the very bottom rung of society and then they get
a few months of treatment and they’re virtually ready
to run Morgan Stanley? It’s just too implausible.” She said, I’ve never even heard
of anything like it.” And I said, “The fact that
you’ve never heard of it is an indication that it is ‘news’.” (Laughter) (Applause) “And you are a news magazine.” So after a certain amount of negotiation, they agreed to it. But I think a lot of what they said was connected in some strange way to this distaste that people still have for the idea of treatment, the notion that somehow if we went out and treated a lot of people
in indigent communities, that would be an exploitative thing to do, because we would be changing them. There is this false moral imperative that seems to be all around us that treatment of depression, the medications and so on,
are an artifice, and that it’s not natural. And I think that’s very misguided. It would be natural
for people’s teeth to fall out, but there is nobody
militating against toothpaste, at least not in my circles. And people then say,
“Well, but isn’t depression part of what people
are supposed to experience? Didn’t we evolve to have depression? Isn’t it part of your personality?” To which I would say, mood is adaptive. Being able to have sadness and fear and joy and pleasure and all of the other moods that we have, that’s incredibly valuable. And major depression
is something that happens when that system gets broken. It’s maladaptive. People will come to me and say, “I think, though, if I just stick it
out for another year, I think I can just get through this.” And I always say to them,
“You may get through it, but you’ll never be 37 again. Life is short, and that’s a whole year you’re talking about giving up. Think it through.” It’s a strange property
of the English language, and indeed of many other languages, that we use this same word, depression, to describe how a kid feels when it rains on his birthday, and to describe how somebody feels the minute before they commit suicide. People say to me, “Well, is it
continuous with normal sadness?” And I say, in a way it’s continuous
with normal sadness. There is a certain amount of continuity, but it’s the same way there’s continuity between having an iron fence
outside your house that gets a little rust spot that you have to sand off
and do a little repainting, and what happens if you leave
the house for 100 years and it rusts through
until it’s only a pile of orange dust. And it’s that orange dust spot, that orange dust problem, that’s the one
we’re setting out to address. So now people say, “You take these happy pills,
and do you feel happy?” And I don’t. But I don’t feel sad
about having to eat lunch, and I don’t feel sad about
my answering machine, and I don’t feel sad
about taking a shower. I feel more, in fact, I think, because I can feel sadness
without nullity. I feel sad about
professional disappointments, about damaged relationships, about global warming. Those are the things
that I feel sad about now. And I said to myself, well,
what is the conclusion? How did those people who have better lives even with bigger depression
manage to get through? What is the mechanism of resilience? And what I came up with over time was that the people
who deny their experience, the ones who say,
“I was depressed a long time ago and I never want to think about it again and I’m not going to look at it and I’m just going
to get on with my life,” ironically, those are the people who are most enslaved by what they have. Shutting out the depression
strengthens it. While you hide from it, it grows. And the people who do better are the ones who
are able to tolerate the fact that they have this condition. Those who can tolerate their depression are the ones who achieve resilience. So Frank Russakoff said to me, “If I had it again to do over, I suppose I wouldn’t do it this way, but in a strange way, I’m grateful for what I’ve experienced. I’m glad to have been
in the hospital 40 times. It taught me so much about love, and my relationship with
my parents and my doctors has been so precious to me,
and will be always.” And Maggie Robbins said, “I used to volunteer in an AIDS clinic, and I would just talk and talk and talk, and the people I was dealing with weren’t very responsive, and I thought, ‘That’s not very friendly
or helpful of them.’ And then I realized, I realized that they
weren’t going to do more than make those
first few minutes of small talk. It was simply going to be an occasion where I didn’t have AIDS
and I wasn’t dying, but could tolerate the fact that they did and they were. Our needs are our greatest assets. It turns out I’ve learned to give all the things I need.” Valuing one’s depression does not prevent a relapse, but it may make the prospect of relapse and even relapse itself
easier to tolerate. The question is not so much of finding great meaning and deciding your depression has been very meaningful. It’s of seeking that meaning and thinking, when it comes again, “This will be hellish, but I will learn something from it.” I have learned in my own depression how big an emotion can be, how it can be more real than facts, and I have found that that experience has allowed me to experience
positive emotion in a more intense and more focused way. The opposite of depression
is not happiness, but vitality, and these days, my life is vital, even on the days when I’m sad. I felt that funeral in my brain, and I sat next to the colossus at the edge of the world, and I have discovered something inside of myself that I would have to call a soul that I had never formulated
until that day 20 years ago when hell came to pay me a surprise visit. I think that while I hated being depressed and would hate to be depressed again, I’ve found a way to love my depression. I love it because it has forced me to find and cling to joy. I love it because each day I decide, sometimes gamely, and sometimes against the moment’s reason, to cleave to the reasons for living. And that, I think,
is a highly privileged rapture. Thank you. (Applause)

About the author

Comments

  1. It has finally hit me at 50 and I am glad to hear someone that understands.I WILL get healthy.I would do anything to meet this great man.Maybe one day

  2. ❤❤️❤❤️❤❤️❤ "the fact you never heard of it means that it's – news … and you are a news magazine"

  3. You are a genius Andrew Solomon, just love this Tedx Talks, one of my top 10 for sure!!! The poem is amazing, I recall the Emily Dickinson piece, she also, a genius.

  4. This talk is comic gold, so many things correctly related but wrongly concluded. Didn't laugh so much in a long time – the movie 'Du Levande' comes to mind.

    Just why is unhappiness so funny? Are boring people funny? I guess it depends who is looking.. I mean do they bore themselves?

    Once there was a woman who asked me something about her tears (it was a secret, an open one, perhaps for some). She said, that there was a time where she just had to cry and didn't know why. I said, that has to do with true sadness and that it is the same with laughing – if you truly laugh, you have no reason for it, and so it also is with tears. It's a gift, yes yes! She gave it to herself – I just hope that she will not forget, for it would make the whole world sad…

  5. This clown is a globalist shill. the liberal platform is designed to appeal to angry people. example. identity politics..= everyone is against us.

  6. The problem with todays society is that it´s hard to connect, getting a feeling of truly belonging and creating an identity. Society simply has become too corrupt, complex and irrelevant to the individual.

  7. Thank you for sharing. Very well spoken. I can relate to most of it. I agree today’s treatments are still in the dark ages and it is a tragedy. My concern when it comes to society as a whole is a lack of empathy, without it educating people about mental illness falls on def ears. But all we can do is try and you have certainly done that. May joy find its way to you.

  8. well said! good for u to share!.. its awful..if this helps, from what i have experienced, when a person goes through extreme emotional type stress, it negatively affects the core of our physiology, the good gut bacteria..bacteria makes up approximately 90% of our body, so if healthy gut bacteria becomes out of balance, this affects our mood and even our perceived emotions..and digesting nutrients from even healthy food, also becomes stunted..to attempt to climb back out from the dark pit, perhaps try to re-establish a healthy microbiome by drinking small amounts of organic kefir, and berries throughout the day, only for a few days? it took me 5 days.. along with liquids of colloidal minerals and lemon juice with bio available Vit C powder, apple cider vinegar in filtered warm water, and pure coconut water from baby coconuts, all as separate drinks..just have everything in small doses over each day, this will hopefully help reboot yr good gut bacteria, which should help the enzymes as well..take nice nature walks each day, and try get sleep during the night…if this helps you break free, then thats awesome..

  9. hi…i am a survivor of Depression…your talk is awesome…and spot-on…thanks for sharing your amazing journey

Leave a Reply

Your email address will not be published. Required fields are marked *